Harvard Mental Health Letter

Medication Update: Research raises questions about long-acting antipsychotics

Medication Update

Research raises questions about long-acting antipsychotics

When a person with psychosis has trouble complying with a medication regimen, one option offered is an injection of a long-acting antipsychotic. Previous studies concluded that such injections increase the likelihood of treatment adherence.

However, a study of nearly 2,700 patients being treated in the community suggests otherwise. It found that most patients receiving the injections eventually opted out of them, and that many chose instead to return to oral medications.

Researchers analyzed office visits and pharmacy claims made over a four-year period by participants in the California Medicaid program who had received the long-acting injectable form of one of three antipsychotics: fluphenazine (Prolixin), haloperidol (Haldol), or risperidone (Risperdal). When researchers reviewed the data, they found that 180 days after beginning treatment, only a small minority of patients were still taking the long-term injections. About 5% of those taking fluphenazine, 10% of those taking haloperidol, and 2.6% of those taking risperidone were still receiving injections. Most of those who had stopped receiving long-term injections (at least three in four, with the exact proportion depending on the medication) had switched back to oral antipsychotics within 45 days after discontinuing the long-term injections.

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